II. Definitions
- Allergic Triad (Samter's Triad)
- Allergic constellation centered around Aspirin (or NSAID) allergy or sensitivity
- Associated with Nasal Polyps and Eosinophilic Asthma (T2 Asthma)
III. Pathophysiology
- Associated with disordered Arachidonic Acid metabolism (cyclooxygenase mediated to inflammatory agents)
IV. Associated Conditions
- Aspirin-induced Asthma
- Rhinorrhea
- Nasal Polyps
- Chronic Sinusitis
- Conjunctival edema
V. Course
- Onset as perennial Vasomotor Rhinitis
- Develops into hyperplastic Rhinosinusitis, Nasal Polyps
- Asthma is typically severe from onset with frequent exacerbations
VI. Causes
- Aspirin
- Cross-reactivity with NSAIDs
- Indomethacin
- Naproxen
- Ibuprofen
- Fenoprofen
- Mefenamic acid
- Phenylbutazone
VII. Labs: Markers
- See Extrinsic Asthma
- Associated with increased urinary LTE4 > 166 pg/mgCr
VIII. Management
- Avoid Aspirin and causative NSAIDs above
- Use safe alternative Analgesics instead
- Salsalate
- Acetaminophen
- Treat Aspirin-induced Asthma
- Leukotriene Modifiers (e.g. Sinulair)